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Background: In the Internet era, many web-based appointment systems for hospitals have been established to replace traditional systems. Our study aimed to highlight the features of online appointment systems for hospitals in Taiwan, where patients can visit outpatient departments without a referral., Methods: All hospitals online appointment systems were surveyed in October 2018. Features of first-visit registrations were analyzed and stratified according to the hospitals' accreditation levels., Results: Of the 417 hospitals, 59.7% (249) had public online appointment systems. For first-visit patients, only 199 hospitals offered the option of making appointments online from 7 to 98 (mean 38.9) days prior to the appointment itself. Before appointments, 68 (34.2%) hospitals recommended specialties for patients to choose according to their symptoms, and only 11 (5.5%) had a function for sending messages to doctors. After appointments, 176 (88.4%) provided links to real-time monitoring of outpatient service progress., Conclusions: More than half of the hospitals in Taiwan have public online appointment systems. However, most of these systems simply fulfill the function of registration, and rarely take the opportunity to improve efficiency by gathering information regarding patients' medical history or reasons for making the appointment.

Background : Social media advertising has become increasingly influential in recent years. Because Facebook has the most active users worldwide, many hospitals in Taiwan have created official Facebook fan pages. Our study was to present an overview of official Facebook fan pages of hospitals in Taiwan. Methods : All 417 hospitals were surveyed about their use of Facebook fan pages in December 2017. The last update time, posts in the past 30 days, number of “Likes”, and other features were analyzed and stratified according to the accreditation statuses of the hospitals. Results : In Taiwan, only 51.1% ( n = 213) of the hospitals had an official Facebook fan page. Among these hospitals, 71.8% ( n = 153) had updated their pages in the past 30 days, although 89.2% ( n = 190) provided online interactions. Academic medical centers tended to have more “Likes” than regional and local community hospitals (on average 5947.4, 2644.8, and 1548.0, respectively). Conclusions : In spite of the popularity of Facebook among the general population, most hospitals in Taiwan do not seem to make good use of this kind of social media. The reasons for the use and nonuse of Facebook on the part of both hospitals and patients deserve further investigation.

The objectives of this study were to try to determine the reasons of the external Ca(2+) and Na(+) enhancement of Cd(2+) and Cu(2+) resistance in fish. Tilapia larvae at 3 days posthatch were exposed to (A) 0 (control), 40 microg/L Cd(2+), 40 microg/L Cd(2+) + 2 mM Ca(2+) (Cd/hyper-Ca), and 2 mM Ca(2+) or (B) 0 (control), 75 microg/L Cu(2+), 75 microg/L Cu(2+) + 0.52 mM Na(+) (Cu/hyper-Na), and 0.52 mM Na(+). After 48 hours, results indicated that (1) Cd/hyper-Ca and Cu/hyper-Na treatments showed decreased growth inhibition induced by the metals; (2) metal accumulation in Cd/hyper-Ca-treated larvae was lower compared with those exposed only to Cd; and (3) metallothionein (MT) expression was significantly higher in Cu/hyper-Na-treated larvae than in the group treated with Cu only. Taking all of this into account, either supplementary Ca(2+) or Na(+) in ambient water may help fish to maintain Ca(2+) or Na(+) homeostasis, which could decrease metal accumulation and its detrimental effects. Consequently, the fish increase MT expression and retard the growth inhibition caused by metals.